Why Medicare for All Will/Won’t Work

Senator Sanders’s Medicare for All Act merits strong support from all political constituencies.

For conservatives, Medicare for All (single payer) should appeal because it will control costs. With Medicare for All, one payer sets prices, so hospitals and drug companies can no longer gouge us. Administrative costs, currently estimated to be as much as one-third of every health care dollar, will be significantly reduced without the complexities of billing multiple insurers and plans.

For progressives committed to universal coverage, they see that reforming the current system based on private insurance can reduce the numbers of uninsured, but not create universal access. Some 28 million Americans still have no coverage. A large percentage of the insured have trouble affording their premiums, deductibles and out-of-pocket costs. Such costs lead individuals to put off needed care, resulting in alarmingly high rates of preventable deaths. In a piecemeal system, factors such as changes in employment status also result in gaps in coverage.

So whether the appeal is cost control or universal access, Medicare for All makes sense. And, it will save lives.

ELLEN OXFELD, MIDDLEBURY, VT.

To the Editor:

Senator Bernie Sanders, from the tiny state of Vermont, makes a compelling argument for converting the payment system for health care to a single-payer system — Medicare for All. But he does not offer any mechanism for funding this new entitlement.

Also missing from his Op-Ed article is the fact that Vermont’s political leadership seriously considered a single-payer system in 2011, but rejected it because it would have increased the state budget by 45 percent.

He also doesn’t mention the prospect of health care rationing, a concept that Canadians are very familiar with and bypass by crossing into the United States.

CHARLES H. GESSNERMARBLEHEAD, MASS.

To the Editor:

Bravo, Senator Sanders! As a physician for 50 years and an activist with Physicians for a National Health Program, I am overjoyed to see this common-sense legislation. This morning, wearing a T-shirt with “Single-Payer Health Care for People Not for Profit” on the front, I was asked, “What is that?”

“Medicare for All,” I replied.

“Oh, I’m for that” was the reply. “It’s so simple!”

Now comes the big struggle against those who profit from our current system. We must show our legislators that their jobs are in jeopardy if they fail to support this bill.

ELIZABETH ROSENTHALLARCHMONT, N.Y.

To the Editor:

If we offered Medicare for All, human nature and basic economic theory might not comply, which is why every socialist-type idea leads to waste, inefficiency and higher cost.

We could limit the damage by allowing people to opt out and buy private insurance, and allow doctors to charge whatever the market will bear and let consumers decide which doctor is worth the extra cost. This economic discipline will limit the damage. (Today, when doctors’ fees are cut, they can simply perform more procedures, and the costs keep going up.)

Ideally, the government should simply mandate that every citizen buy insurance, issue vouchers to those unable to buy, and act as “insurer of last resort” for those who pose enormous burdens.

We trust the free market to raise quality and lower costs for our cellphones, plumbers, clothes, etc., and there is no crisis in getting access to any of these services or products. Where government does impose controls — like rent control, the New York City subway and health care — the quality goes down and the costs go up.

The progressive idea that all citizens — rich and poor — should enjoy the same level of health care is noble, to be sure, but unworkable and will not eliminate the waste and inefficiency rife in health care.

ARI WEITZNER, NEW YORK

The writer is an ophthalmologist.

A version of this article appears in print on , on Page A24 of the New York edition with the headline: Why Medicare for All Will/Won’t Work. Order Reprints | Today’s Paper | Subscribe